3rd European Conference on Child Abuse and Neglect. Date: May De Meervaart, Amsterdam, the Netherlands

3rd European Conference on Child Abuse and Neglect Date: 25 – 27 May 2016 De Meervaart, Amsterdam, the Netherlands Edition of: SCEM Postbus 21 4196...
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3rd European Conference on Child Abuse and Neglect Date: 25 – 27 May 2016 De Meervaart, Amsterdam, the Netherlands

Edition of:

SCEM Postbus 21 4196 ZG Tricht

Accreditation Accreditation is granted by: Nederlandse Vereniging voor Kindergeneeskunde (16 pt) NvvP Nederlandse Vereniging voor Psychiatrie (16 pt) Accreditatie Bureau Sociale Geneeskunde (16 pt) VVAK (vertrouwensartsen) (15 pt) SKjeugd (1 pt) The European Accreditation Council for Continuing Medical Education (EACCME)UEMS (18 pt)

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8

Welcome

9

Programme

10

Organising Committee

16

Speakers

17

Abstracts Speakers

19

Neglected child neglect? prof.dr. L.R.A. Alink

20

We need to differentiate and integrate short-term & long-term safety in the family S. van Arum MSc

21

Evidence based treatment for young victims of sexual trauma dr. I.A.E. Bicanic

22

Munchausen in court - who is telling tales: the doctor or the suspect? R. Bilo MD

23

Signs of child sexual abuse, inter- and intra rater reliability T.F. Bosschaart MD

24

Real and unreal controversies in abusive head trauma C. Christian MD

25

Metabolic and genet Child Abuse Pediatrician ic mimickers of child abuse C. Christian MD

26

Follow-up parents on the ER R.J. Drijfhout M.A.

27

Child abuse in the light of the human rights' convention mr.drs. W.L.J.M. Duijst

28

The Amsterdam sexual abuse case (ASAC) in day care centers: A study of sexual abuse in very young children E.M. van Duin PhD

29

Emotional neglect, parent-child interaction and language development in young children of parents with psychosocial problems M.R. Gigengack MSc

30

Children's mental health and well-being after parental intimate partner homicide A.G. Groot

31

3

Effect study on VoorZorg, The Dutch Nurse Family Partnership S. van den Heijkant & J. Mejdoubi

32

One-year follow-up of children of parents attending hospital emergency departments after intimate partner violence, substance abuse or suicide attempt dr. E.M.M. Hoytema van Konijnenburg PhD

34

Care for young carers; from neglect to support P.J. Jonker MD

35

Prenatal child abuse and neglect I. van Kamp & drs. E.A. Landsmeer

36

Evidential power of pyhiscal findings in child sexual abuse W.A. Karst MD & drs. L.R.A. van den Berg

37

Performing a physical examination in child sexual abuse: Why and how? W.A. Karst MD

38

The Empathic brain prof. C.M. Keysers

39

A life full of love and happiness is possible after sexual abuse drs. M. Kimmel

40

Why parents might kill their children prof.dr. F. Koenraadt

41

Coöperation between medical professionals and public prosecutors in PCF cases mr. E.H.G. Kwakman

42

No kids in the middle drs. M.J. van Lawick

43

Abusive Abdominal Injuries: How do you find them and what do you do? D. Lindberg MD; Assc. Prof.

44

The other children: Occult injuries in siblings and contacts D. Lindberg MD; Assc. Prof.

45

What happened to you? (Interviewing young children during police investigations) B.N. Nolet MCI

46

How can CenteringPregnancy and CenteringParenting contribute to the prevention of child abuse dr. M.E. Rijnders

47

Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline in Foster Care: VIPP- FC – A pilot study N.K. Schoemaker MSc

48

Talking about child maltreatment with parents; resolutions approach drs. J.W. Sepers

49

4

Investigative interviewing of child witness by the Dutch police J. van der Sleen MSc

50

Preventing Abusive Head Trauma in Children dr. B.E. van Sleuwen

51

Combining forensic and Pediatric experience: 1 and 1 becomes 3! A.H. Teeuw & drs. H.C. Terlingen & drs. I.M.B. Russel

52

Effects of a community approach to domestic violence in the G4 drs. B. Tierolf

53

Workshop Photo Documentation P. Varkevisser & M. Van Velthoven & H.G.T. Nijs MD.PhD

54

A triage-tool to assess danger and structural unsafety in family systems L. Vogtländer MSc

55

Improving the parental relationship enhances safety for children drs. C.L.A. Wagenaar

56

The power of partnership J. Wiggerink & M. Vogel

57

Challenge your beliefs P.I.M. Worm

58

Abstracts Abstractspeakers

59

Prevalence of victimization and poly-victimization of children in Saudi Arabia: Results from ICAST study dr. Al-Eissa

60

Adverse childhood experiences and association with health-risk behaviors and co-morbidities among adults in Saudi Arabia dr. M.M. Almuneef

61

Utilizing predictive analytics to forecast child maltreatment M.B. Bachmann Associate Professor

62

Preventing Child Sexual Abuse: Body Safety Training Programme for Preschoolers in Turkey Citak Tunc Gulseren MSc

63

Determining the Appropriateness of the WIST III with Turkish Preschoolers Citak Tunc Gulseren MSC

64

Will a clinical prediction tool for abusive head trauma help or hinder social workers, police and lawyer’s investigations? L.E. Cowley

65

5

Building a bridge between health care professionals and Safe at Home in case of suspected child abuse A. Custers MD MSc

66

Guilt and shame as predictors of maltreatment mothers' empathy, aggressiveness, parental competence and Quality-Of-Life Davidson-Arad Bilha

67

Murdered children and children who have mothers who have been killed by their partner or former partner in Iceland, during a thirty year period. An explorative study. F.J.F. Dr. Freysteinsdóttir

68

Parenting in the Shadow of Childhood Maltreatment dr. G. Harel PhD

69

Interventions to stop child abuse: treating systemic and individual drivers combined in Multisystemic Therapy for Child Abuse and Neglect drs. F.N. Kamphuis

70

The assocation between psychological traumatization and executive functions in children and adolescents: A meta-analytic approach R. Op den Kelder MSc

71

Supervisory Neglect, Externalizing Behaviors, Substance use, and Extended Family Support B.S. Kors

72

Child abuse and neglect in South Africa: A review of policy and practice prof. K. Mwaba

73

Child abuse and low care predict depressive sympsoms and stress in Uruguayan pregant women. D.E. Olazábal PhD

74

Knowledge and attitude of professionals in the Netherlands on highconflict divorces B. van Pol MSc

75

Methodological Moderators in Prevalence Studies on Child Maltreatment: Review of a Series of Meta-Analyses dr. M.J.L. Prevoo

76

Neonatal abstinence syndrome - is that abuse an unborn child? Saftic V MD, PhD

77

Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline in Foster Care: VIPP- FC – A pilot study N.K. Schoemaker MSc

78

The diagnostic value of a checklist in screening for child abuse in Out-of-hours Primary Care. drs. M.C.M. Schouten

79

6

Evaluation of a Life-Skills Programme ('Boost') for Young Care-leavers dr. W. Sims-Schouten

80

Evaluation of a community-based wraparound intervention to prevent child maltreatment within high-risk families dr. A. Stokes

81

An evaluation a Parent and Infant (PIN) community-based wraparound intervention for vulnerable parents and infants dr. A. Stokes

82

Tools within the chat that contribute to the realignment between guidance and the need of youngsters I. Van Campenhout

83

Epidemiology and screening of non-accidental burns in children in a Dutch burn centre M.H. van de Merwe MD

84

Practice guidelines on child abuse and neglect R.M. Vink

85

Reducing The Effect of Observed Family Violence on Children prof. S.W. Worthy

86

Notes

87

7

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neglect

8

Welcome Dear colleagues, members and friends, On behalf of the conferencecommittee, it is our pleasure to welcome you to the 3rd EUropean Conference on Child Abuse and Neglect. For the third time the Academic Medical Center Amsterdam and Netherlands Forensic Institute and the University Medical Center Utrecht, organises the 3rd European Conference on Child Abuse and Neglect. We are very proud that we are able to offer you an innovative and attractive scientific program about the consequences of Child abuse and neglect. In this conference we bring together a wide range of specialists in the field of child abuse and neglect, ranging from paediatricians to social workers to lawyers. The aim of our conference is, first of all, to present to the audience a state-of-the-art overview of this difficult field of expertise in health care. Secondly, we hope that by bringing together an international audience, cross-border cooperation can be established and attendees will form international social and professional relations. We are pleased to welcome you in Amsterdam – the beating heart of the Netherlands. Thank you for joining us and bringing your expertise to our gathering. Not only the outstanding scientific program but also every single congress participant with his or her individual input will contribute to the success of this joint conference. We hope you will leave this conference not only with new ideas and exemples of good practise but also with new networks and colleagues who together will continue to make a difference to the lives of children who are abused and neglected. Welcome to Amsterdam!

Rian H. Teeuw Paediatrician, expert in Child Abuse & Neglect Child Abuse & Neglect Team Emma Children's Hospital / Academic Medical Center Amsterdam

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Programme Wednesday 25 May 2016 Red Hall

09.00 – 12.30

General topics

09.00 – 09.10 Opening and Welcome Organizing Committee 09.10 – 09.30 Welcome E. van der Laan, Major of Amsterdam and chairman Task Force Child abuse 09.30 – 10.30 Neglected child neglect Lenneke Alink, Professor of Forensic family studies, Leiden University, Leiden, The Netherlands 10.30 – 11.00 Coffee break 11.00 – 11.45 Evidential power of physical findings in child sexual abuse Wouter Karst, Forensic physician, Netherlands Forensic Institute, The Hague, The Netherlands & Loes van den Berg, Pediatrician, Helse Nord-Trøndelag Sykehuset Levanger, Levanger, Norway 11.45 – 12.30 The impact of ongoing threat of war and violence on parents and children To be discussed 12.30 – 13.30 Lunch 12.45 – 13.30 Poster SLAM Sessions – moderator Marie-José van Hoof 13.30 – 16.30 Focus sessions 16.30 – 17.30 Welcome reception 13.30 – 16.30

Focus sessions, simultaneous Aspects of sexual abuse

13.30 – 14.15 Performing a physical examination in child sexual abuse: Why and how? Wouter Karst, Forensic physician, Netherlands Forensic Institute, The Hague, The Netherlands 14.15 – 15.00 Signs of child sexual abuse, inter- and intra rater reliability Thekla Bosschaart, medical doctor Academic Medical Center, Amsterdam, The Netherlands 15.00 – 15.30 Tea break 15.30 – 16.15 The Amsterdam sexual abuse case (ASAC) in day care centers: A study of sexual abuse in very young children Esther van Duin, Child psychologist, PhD, Academic Medical Center, Amsterdam, The Netherlands Psychosocial aspects of abuse and neglect 13:30 - 14:00 One-year follow up of children of parents attending hospital emergency departments after intimate partner violence, substance abuse or suicide attempt Eva Hoytema van Konijnenburg, Physician-researcher, Academic Medical Center, Amsterdam, The Netherlands 14:00 - 14:30 Emotional neglect, parent-child interaction and language development in young children of parents with psychosocial problems Maj Gigengack, PHD Student, Academic Medical Center, Amsterdam, The Netherlands 14:30 – 15:00 Effects of a community approach to domestic violence in the G4 Bas Tierolf, Senior Researcher, Verwey-Jonker Instituut, Utrecht, The Netherlands 15:00 - 15:30 Tea break 15:30 - 16:15 Improving the parental relationship enhances safety for children Karin Wagenaar, clinical psychologist, family therapist, EFT therapist, Pro Persona, Utrecht, The Netherlands Judical aspects of abuse and neglect 13:30 – 15:00 Investigative interviewing of child witness by the Dutch police Jannie van der Sleen, Kinterview recherche psychologist, forensic psychologist, The Netherlands 15:00 - 15:30 Tea Break 15:30 - 16:15 What happened to you? (Interviewing young children during police investigations) Bob Nolet, police detective, Bureau Zedenpolitie Amsterdam, The Netherlands

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Workshop Photo Documentation (max. 15 persons, 45 minutes) In this workshop of 45 minutes the principles of photo documentation will be explained. After a short introduction of the method (technical settings and sequence of photography) you will get the opportunity to shoot your own set of photographs of a (fictitious or real) injury. Feedback will be given by experienced medical forensic photographers. The focus is to improve your images for both medical and forensic purposes, by following strict procedures (also helpful when someone else actually takes the photographs, eg. a medical or police photographer). Afterwards you will receive a mnemonic (in English): a ‘credit card’ with a short checklist. Huub Nijs & Peter Varkevisser Only place for 15 persons per 45 minutes. Times: 13.30 – 14.15 h or 14.15 – 15.00 h or 15.30 – 16.15 h

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Programme Thursday 26 May 2016 Red Hall

09.00 – 12.30

General topics

09.00 – 09.05 Opening and Welcome Organizing Committee 09.05 – 09.50 Real and unreal controversies in abusive head trauma Cindy Christian, Child Abuse Pediatrician, The Children’s Hospital of Philadelphia, Philadelphia, USA 09.50 – 10.35 The Other Children: Occult injuries in siblings and contacts Daniel Lindberg, Physician (Emergency Medicine & Child Abuse Pediatrics), University of Colorado School of Medicine, Aurora, USA 10.35 – 11.00 Coffee break 11.00 – 11.45 Abstract presentations 11.45 – 12.30 Evidence based treatment for young victims of sexual trauma Iva Bicanic, clinical psychologist and researcher, University Medical Center Utrecht, Utrecht, The Netherlands 12.30 – 13.30 Lunch 12.45 – 13.30 Poster SLAM Sessions – moderator Michaela Hilhorst 13.30 – 16.30 Focus sessions 13.30 – 16.30

Focus sessions, simultaneous Aspects of physical abuse and neglect

13.30 – 14.15 Preventing Abusive Head Trauma in Children Bregje van Sleuwen, research scientist, consultant, TNO, Leiden, The Netherlands 14.15 – 15.00 Metabolic and genet Child Abuse Pediatrician ic mimickers of child abuse Cindy Christian, Child Abuse Pediatrician, The Children’s Hospital of Philadelphia, Philadelphia,USA 15.00 – 15.30 Tea break 15.30 – 16.30 Radiology aspects on child abuse Rick van Rijn, Radiologist, Emma Children’s Hospital–Academic Medical Center, Amsterdam, The Netherlands Psychosocial aspects of abuse and neglect 13:30 - 14:15 Antenatal prevention of CAN Remy Vink, socioloog onderzoeker, TNO, Leiden, The Netherlands 14:15 - 15:00 How can CenteringPregnancy and CenteringParenting contribute to the prevention of child abuse Marlies Rijnders, research-midwife, TNO, Leiden, The Netherlands 15:00 - 15:30 Tea break 15:30 - 16:00 Effect study on VoorZorg, The Dutch Nurse Family Partnership Jamila Mejdoubi, Researcher, Atria, Amsterdam, The Netherlands & Silvia van den Heijkant, Senior Investigator, VUMC, Amsterdam, The Netherlands 16:00 - 16.30 The Empathic brain Christian Keysers, scientist, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands Judical aspects of abuse and neglect 13:30 - 14:15 Follow-up parents on the ER Roely Drijfhout, Content expert, Augeo, Driebergen-Rijsenburg, The Netherlands 14:15 - 15:00 A triage-tool to assess danger and structural unsafety in family systems Linda Vogtländer, child an adolescent psychiatrist, De Forensische Zorgspecialisten, Utrecht, The Netherlands 15:00 - 15:30 Tea Break 15:30 - 16:00 Child abuse in the light of the human rights’ convention Wilma Duijst, Forensic physician, Netherlands Forensic Institute, The Hague, The Netherlands 16:00 - 16:45 We need to differentiate and integrate short-term and long-term safety in the family Sander van Arum, Expert consultant, developer & tutor in the field of domestic violence & child abuse, Utrecht, The Netherlands

12

Workshop Photo Documentation (max. 15 persons, 45 minutes) In this workshop of 45 minutes the principles of photo documentation will be explained. After a short introduction of the method (technical settings and sequence of photography) you will get the opportunity to shoot your own set of photographs of a (fictitious or real) injury. Feedback will be given by experienced medical forensic photographers. The focus is to improve your images for both medical and forensic purposes, by following strict procedures (also helpful when someone else actually takes the photographs, eg. a medical or police photographer). Afterwards you will receive a mnemonic (in English): a ‘credit card’ with a short checklist. Huub Nijs & André van den Bos / Maud Velthoven Only place for 15 persons per 45 minutes. Times:13.30 – 14.15 h or 14.15 – 15.00 h or 15.30 – 16.15 h

13

Programme Friday 27 May 2016 09.00 – 12.00

Focus sessions, simultaneous Aspects of physical abuse and neglect

Chairmen: Marie-José van Hoof

09:00 – 09:45 Abusive abdominal injuries: how do you find them and what do you do? Daniel Lindberg, Physician (Emergency Medicine & Child Abuse Pediatrics), University of Colorado School of Medicine, Aurora, USA 09:45 – 10:30 Challenge your beliefs Patries Worm, pediatrician child abuse counselor, Veilig Thuis Gelderland, Nijmegen, The Netherlands 10:30 – 11:00 Coffee break 11.00 – 11.30 Cooperation between medical professionals and public prosecutors in PCF cases Eva Kwakman National Public Prosecutor on domestic violence and sexual crimes, National Public Prosecution Office, Utrecht, The Netherlands 11:30 – 12:00 Munchausen in court - who is telling tales: the doctor or the suspect? Rob Bilo, Forensic physician and consultant in forensic pediatrics, Netherlands Forensic Institute, The Hague, The Netherlands Psychosocial aspects of abuse and neglect Chairmen: Henrique Sachse 09:00 – 09:45 No kids in the middle Justine van Lawick, clinical psychologist, Lorentzhuis, The Netherlands 09:45 – 10:30 Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline in Foster Care: VIPP- FC – A pilot study Nikita Schoemaker, PhD student and VIPP-SD trainer, Leiden University Medical Center, Leiden, The Netherlands 10:30 - 11:00 Coffee break 11:00 - 11:30 Care for young carers; from neglect to support Els Jonker, Medical specialist for Public Health Care, Dutch Association for Youth Health Care, Deventer, The Netherlands 11:30 – 12:00 Prenatal child abuse and neglect Noor Landsmeer, Pediatrician social pediatrics, Rivierduinen, GGZ, Leiden, The Netherlands & Inge van Kamp, Rivierduinen, GGZ, Leiden, The Netherlands Forensic medical aspects of abuse and neglect Chairmen: Michaela Hilhorst 09:00 - 09:45 The power of partnership Joke Wiggerink, assistant director and Signs of Safety trainer, Jeugdbescherming Noord, Groningen, The Netherlands & Marieke Vogel, assistant director and Signs of Safety trainer, Jeugd-bescherming Noord, Groningen, The Netherlands 09:45 - 10:30 Talking about child maltreatment with parents; resolutions approach Annemariek Sepers, psychologist/psychotherapist/cbt therapist, Rivierduinen, Leiden, The Netherlands 10:30 - 11:00 Tea Break 11:00 - 12:00 Combining forensic and pediatric experience: 1 and 1 becomes 3! Ingrid Russel, Pediatrician social pediatrics, UMCU & Rian Teeuw, pediatrician, Academic Medical Center, Amsterdam, The Netherlands & Heike Terlingen, forensic pediatrics, Netherlands Forensic Institute, The Hague, The Netherlands

12:00 – 13:00 Lunch 12.15 – 13.00

Poster SLAM Sessions – moderator Henrique Sachse

Red Room

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Red Hall

13.30 – 16.30

Concluding session

13:00 - 13:45 Children’s Mental Health and Well-Being after parental intimate partner homicide Arend Groot, social worker Psychotraumacenter, Univerity Medical Center Utrecht, Utrecht, The 13:45 - 14:30 Why parents might kill their children Frans Koenraadt, professor in forensic pscychiatry and psychology, University of Utrecht, Utrecht, The Netherlands 14:30 - 15:00 Tea Break 15:00 - 15:30 A life full of love and happiness is possible after sexual abuse Marianne Kimmel, Coach, Motivational Speaker and Inspirer, ContactSignals, Sint Maarten, The 15:30 – 15:45 Special performance 15:45 - 16:15 Word of goodbye Organizing Committee

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Organizing Committee Thekla Bosschaart PhD-student Child Abuse & Neglect Team Emma Children's Hospital / Academic Medical Center Amsterdam

Sonja N. Brilleslijper-Kater Child psychologist, expert in Child Abuse & Neglect Child Abuse & Neglect Team Emma Children's Hospital / Academic Medical Center Amsterdam

Michaela Hilhorst Pediatrician, forensic doctor Emma Children's Hospital / Academic Medical Center Amsterdam

Marie-José van Hoof Child and adolescent psychiatrist and orthopedagoge TOPGGZ Psychotraumacenter and Mental Health Institute GGZ Kinderen en Jeugd Rivierduinen

Wouter Karst Forensic physician Section Forensic Pediatrics, Department of Forensic Medicine Netherlands Forensic Institute

Ingrid Russel Pediatrician UMC Utrecht location Wilhelmina Children's hospital and head Expertisecenter Child Abuse

Henrique Sachse-Bonhof Physician of Child Abuse and Neglect, physician of Public Health Institute for Youth Health Care, department of Child Abuse and Neglect, Gouda, the Netherlands

Rian H. Teeuw Paediatrician, expert in Child Abuse & Neglect Child Abuse & Neglect Team Emma Children's Hospital / Academic Medical Center Amsterdam

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Speakers prof.dr. L.R.A. Alink, Professor of Forensic family studies, Leiden University, Leiden, The Netherlands S. van Arum MSc, Expert consultant, developer & tutor in the field of domestic violence & child abuse, Utrecht, The Netherlands drs. L.R.A. van den Berg, Pediatrician, Helse Nord-Trøndelag Sykehuset Levanger , Levanger, The Netherlands dr. I.A.E. Bicanic, Clinical psychologist and researcher, University Medical Center Utrecht, Utrecht, The Netherlands R. Bilo MD, Forensic pediatrics, Netherlands Forensic Institute, The Hague, The Netherlands A. van den Bos , Photographer, Netherlands Forensic Institute, The Hague, The Netherlands T.F. Bosschaart MD, Medical doctor, Academic Medical Center , Amsterdam, The Netherlands C. Christian MD, Child Abuse Pediatrician, The Children’s Hospital of Philadelphia, Philadelphia, USA R.J. Drijfhout M.A., Content expert, Augeo, Driebergen-Rijsenburg, The Netherlands mr.drs. W.L.J.M. Duijst, Forensic physician, Netherlands Forensic Institute, The HagueThe Netherlands E.M. van Duin PhD, Child psychologist, Academic Medical Center, Amsterdam, The Netherlands M.R. Gigengack MSc, PHD student, Academic Medical Center, Amsterdam, The Netherlands A.G. Groot, Social workhop/researcher, University Medical Center Utrecht, Utrecht, The Netherlands S. van den Heijkant, Forensic physician, VU Medical Center, The Hague, The Netherlands dr. E.M.M. Hoytema van Konijnenburg PhD, Physician-researcher, Amsterdam Medical Center, Amsterdam, The Netherlands P.J. Jonker MD, Medical specialist for Public Health Care, Dutch Association for Youth Health Care, Deventer, The Netherlands I. van Kamp, Pediatrician social pediatrics, Rivierduinen, GGZ K en J, Leiden, The Netherlands W.A. Karst MD, Forensic physician, Netherlands Forensic Institute, The Hague, The Netherlands prof. C.M. Keysers, Scientist, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands drs. M. Kimmel, Coach, Motivational Speaker and Inspirer, ContactSignals, Sint Maarten, The Netherlands prof.dr. F. Koenraadt, Professor of forensic psychiatry and psychology, University of Utrecht, Utrecht, The Netherlands mr. E.H.G. Kwakman, National Public Prosecutor on domestic violence and sexual crimes, National Public Prosecution Office, Utrecht, The Netherlands mr. E.E. v.d. Laan, Major of Amsterdam, the Netherlands drs. E.A. Landsmeer, Pediatrician social pediatrics, Rivierduinen, GGZ K en J, Leiden, The Netherlands drs. M.J. van Lawick , Clinical psychologist, Lorentzhuis, Haarlem, The Netherlands D. Lindberg MD; Assc. Prof., Physician (Emergency Medicine & Child Abuse

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Pediatrics), University of Colorado School of Medicine, Aurora, USA J. Mejdoubi , Researcher, Atria, Amsterdam, The Netherlands H.G.T. Nijs MD.PhD, Forensic physician, Netherlands Forensic Institute, The Hague, The Netherlands B.N. Nolet MCI, Police detective, Bureau Zedenpolitie Amsterdam, Amsterdam, The Netherlands prof.dr. R.R. van Rijn MD. PhD, Radiologist, Emma Children’s Hospital – Academic Medical Center, Amsterdam, The Netherlands dr. M.E. Rijnders, Research-midwife, TNO, Leiden, The Netherlands drs. I.M.B. Russel, Pediatrician social pediatrics, University Medical Center drs. J.W. Sepers, Psychologist/psychotherapist/cbt therapist, Rivierduinen, Leiden, The Netherlands J. van der Sleen MSc, Recherche psychologist, forensic psychologist, Kinterview, The Netherlands dr. B.E. van Sleuwen, Research scientist, consultant, TNO, Leiden, The Netherlands drs. A.H. Teeuw, Pediatrician, Academic Medical Center , Amsterdam, The Netherlands drs. H.C. Terlingen, Forensic pediatrics, Netherlands Forensic Institute, The Hague, The Netherlands drs. B. Tierolf, Senior Researcher, Verwey-Jonker Instituut, Utrecht, The Netherlands P. Varkevisser, Photographer, Netherlands Forensic Institute, The Hague, The Netherlands M. van Velthoven , Photographer, Netherlands Forensic Institute, The Hague, The Netherlands drs. R.M. Vink, Sociologist and researcher, TNO, Leiden, The Netherlands M. Vogel, Assistant director and Signs of Safety trainer, Jeugdbescherming Noord, Groningen, The Netherlands L. Vogtländer MSc, Child an adolescent psychiarist, De Forensische Zorgspecialisten, Utrecht, The Netherlands drs. C.L.A. Wagenaar, clinical psychologist, family therapist, EFT therapist, Pro Persona, Utrecht, The Netherlands J. Wiggerink, assistant director and Signs of Safety trainer, Jeugdbescherming Noord, Groningen, The Netherlands P.I.M. Worm, pediatrician child abuse counselor, Veilig Thuis Gelderland, Nijmegen, The Netherlands

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Abstract speakers dr. Al-Eissa, Ministry of National Guard Health Affairs, ??, ?? dr. M.M. Almuneef , Ministry of National Guard Health Affairs, ??, ?? M.B. Bachmann Associate Professor, Texas Christian University, Fort Worth, USA Citak Tunc Gulseren MSc, Uludag University Health School, Bursa, Turkey L.E. Cowley, Cardiff University, Cardiff, United Kingdom A. Custers MD MSc, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands Davidson-Arad Bilha, Tel Aviv University, Tel Aviv, Israel F.J.F. Dr. Freysteinsdóttir, University of Iceland, Reykjavík, Iceland dr. G. Harel PhD, Ashkelon Academic College, Ashkelon, Israel drs. F.N. Kamphuis, De Viersprong, Amsterdam, The Netherlands R. Op den Kelder, MSc, University of Amsterdam, Amsterdam, The Netherlands B.S. Kors, University of Tennessee , Knoxville , USA prof. K. Mwaba, University of Western Cape, Cape Town, South Africa D.E. Olazábal PhD, Facultad de Medicina, Montevideo, Uruguay B. Pol, van MSc, Maastricht University, Maastricht, The Netherlands dr. M.J.L. Prevoo, Leiden University, Leiden, The Netherlands Saftic V MD, PhD, Child Protection Centre Zagreb, Zagreb, Croatia N.K. Schoemaker MSc, Leiden University, Leiden, The Netherlands drs. M.C.M. Schouten, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands dr. W. Sims-Schouten, University of Portsmouth, Portsmouth, United Kingdom dr. A. Stokes, National University of Ireland, Maynooth, Kildare, Ireland I. Van Campenhout, VK Brussel, Brussels, Belgium M.H. van de Merwe MD, Maasstad Hospital, Rotterdam, The Netherlands R.M. Vink, TNO, Leiden, The Netherlands prof. S.W. Worthy, Metropolitan State College of Denver, Denver, CO, USA

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Neglected child neglect? Prof.dr. L.R.A. Alink Neglect is the most common type of child maltreatment. Yet, it often does not receive the attention it needs. This lecture will address questions such as: How many children are victims of neglect? How can we measure neglect? What are the risk factors and consequences? Can we prevent it?

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We need to differentiate and integrate short-term & long-term safety in the family S. van Arum MSc Traditionally present and short term safety in relationships with a high risk of relapse in violence or abuse are managed by police and/or child protection services. Structural long-term safety is the aim of services in the field of probation and mental health. The two types of services have always been separate and poorly integrated. The ongoing decentralization of the Social Domain in the Netherlands provides an opportunity to develop a staged approach for which we developed an innovative triagetool to be used by child protection services to assess danger and to indicate which further services are needed for high-risk cases. By implementing this tool a multidisciplinary, interagency process is being created that consecutively addresses safety, risk factors for relapse in abuse and recovery from traumatic events by all family members. Implementation of this process has been and is a difficult but rewarding process.

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Evidence based treatment for young victims of sexual trauma dr. I.A.E. Bicanic Victims of sexual abuse often experience PTSD(symptomatology). If a traumatized child or adolescent is capable of talking about what he or she has experienced, then it is adviced to begin an evidence-based traumafocused intervention for PTSD. However, in practice, children are often not treated according to treatment guidelines. The discrepancy between guidelines and clinical practice will be discussed as well as implications on long term.

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Munchausen in court - who is telling tales: the doctor or the suspect? R. Bilo MD Interdisciplinary cooperation is a ‘conditio sine qua non’ in cases of suspected child abuse. Boundaries between disciplines must be broken in the interest of children and families. Interdisciplinary cooperation requires a way of communicating that is understandable and usable for all cooperating partners. It should be prevented that partners assume that they mean the same when they use certain terms, while in fact they use different definitions of those terms. Therefore the starting point must be to reach agreement about the definition of the used terms before intervening in a family. In fabricated and induced illness (FII), formerly known as Munchausen syndrome by proxy, there may be parental behavior which qualifies without any doubt as a punishable act, eg. withholding of nutrition, poisoning or smothering of children. This implies that the information collected by doctors to reach the "diagnosis" FII gets the status of possible proof of a punishable act, when this type of parental behavior is judicially interpreted in civil or criminal procedures. If this is the case, miscommunication should be prevented in the interest of children and families. The findings during the medical evaluation will have to be translated by doctors in understandable and usable terms, if these findings are used in court procedures. This lecture discusses some of the reasons for miscommunication between medical and judicial professionals in suspected cases of FII and gives examples of the translation of the medical information in understandable and usable terms.

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Signs of child sexual abuse, inter- and intra rater reliability T.F. Bosschaart MD Only little is known so far about the signs of Child Sexual Abuse (CSA), especially in young boys. In 2010 Amsterdam was alarmed by what is now known as the ‘Amsterdam sexual abuse case’ (ASAC). In a special outpatient clinic 130 young children were evaluated for signs of sexual abuse. Through qualitative analyses the signs and symptoms of the evaluated children are examined. The preliminary results of this research will be presented.

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Real and unreal controversies in abusive head trauma C. Christian MD Abusive head trauma is the leading cause of mortality and morbidity related to child physical abuse. There is much scientific controversy related to many issues in this field, some of which are legitimate debates, and others that are less so. This session will review some of the medicallegal controversies related to the diagnosis of abusive head trauma- both real and unreal controversies. Objectives: By the end of this lecture, the participants will: Better understand the literature regarding the mortality related to short falls. Recognize the scientific literature that supports shaking as a mechanism of brain injury in infants. Understand the literature on lucid intervals in abusive head trauma.

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Metabolic and genet Child Abuse Pediatrician ic mimickers of child abuse C. Christian MD The accurate diagnosis of child abuse is critically important for the protection of children and their families. Physicians who care for children are routinely faced with injuries and other medical findings that might represent child abuse or other common or uncommon medical diseases. This talk will review a number of metabolic and genetic diseases that mimic child abuse and abusive head trauma, and will highlight more universal clues that suggest medical illness rather than trauma. Objectives: By the end of this lectures, the participants will: Recognize clinical clues to diseases that may mimic child abuse. List laboratory tests that are used for screening for alternative diseases in cases of suspected abuse. Develop strategies for balancing medical and child welfare investigations as a mandated reporter

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Follow-up parents on the ER R.J. Drijfhout M.A. After working some years in youthcare , dealing with families with educational problems, I swift to working for the Advice and Reporting Centre on Child abuse (AMK) where I worked for fifteen years, investigating reports of child abuse and working with reported families, children and their network. A major component was to advise and train professionals in detecting (and dealing with) signs of child maltreatment and communicating concerns with parents and children.

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Child abuse in the light of the human rights' convention mr.drs. W.L.J.M. Duijst

Child abuse is a matter of human rights. In recent years the ECHR has published a number of verdicts on the subject of child abuse. In these verdicts the ECHR clarifies the way in which a case of (assumed) child abuse has to be approached. A case has to be handled without delay and the investigation has to be thorough and prompt. The protection of the child has to be the first and most important consideration. In this presentation the rights of the parents and the child are elucidated. The aim of the presentation is to make the first step towards implementation of the verdicts of the ECHR into the everyday work of the professional who has to deal with a case of child abuse.

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The Amsterdam sexual abuse case (ASAC) in day care centers: A study of sexual abuse in very young children E.M. van Duin PhD In the so called ‘Amsterdam sexual abuse case’ (ASAC) of 2010, numerous infants and very young children, mostly boys, were victimized by a daycare employee. To date, little research is available on the consequences of sexual abuse at a very young age. A longitudinal study was set up to investigate the consequences of the abuse on the children and their family. Preliminary results of the first assessment that took place in 2013 will be presented.

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Emotional neglect, parent-child interaction and language development in young children of parents with psychosocial problems M.R. Gigengack MSc Psychosocial problems such as domestic violence, a suicide attempt or substance abuse are common. Children growing up in families with these problems might be at risk of emotional neglect. Emotional neglect can have serious negative consequences on the development of children. In young children, a language delay and a disturbed parent-child interaction may be indicators of emotional neglect. To study this, we compared these two indicators in young children age two to seven years of families with psychosocial problems and of families without these problems. The results of this study will give an insight into the consequences of parental psychosocial problems on young children.

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Children's mental health and well-being after parental intimate partner homicide A.G. Groot Parental intimate partner homicide is very shocking, both for the children who lose a parent and for those in their immediate environment. Often children lose both parents, their home and their immediate social environment at once. The homicide itself is often extremely violent. After an intimate partner homicide, drastic decisions about children’s future are made by professionals who may only be exposed to this type of case once or twice in their career. There is a need for evidence-based practice guidelines to assist with these complex decisions. The goal of our study was to examine the impact of parental intimate partner homicide for children and caregivers. We also wanted to give the children and their caregivers a voice. In this presentation we share the results of our study as well as our clinical practice.

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Effect study on VoorZorg, The Dutch Nurse Family Partnership S. van den Heijkant & J. Mejdoubi Background Expectant mothers and young mothers are vulnerable to intimate partner violence (IPV)[1–3]. IPV is associated with physical injury, heart problems, gastrointestinal diseases, psychosocial problems, substance abuse, sexual risk behavior, suicide attempts, and mortality [4,5]. IPV during pregnancy increases a mother’s risk of adverse pregnancy outcomes and the likelihood that her children will develop conduct problems[6,7]. Parents involved in an aggressive relationship are more likely to abuse their child [8]. For children, both experiencing abuse and witnessing abuse are forms of child abuse. It is estimated that among young adult women, IPV is more prevalent than it is among adult women. Pregnant adolescents are approximately six times more likely to be victim of violence by a dating partner compared with their non- pregnant peers[9]. Among pregnant adolescents the prevalence of IPV ranges from 5% to 38%[10]. To protect at- risk mothers and their children from the health and developmental risks of IPV, early intervention is important, if possible, during pregnancy. Targeted interventions designed to prevent or reduce IPV victimization and perpetration are scarce[11,12]. The Nurse- Family Partnership (NFP), developed by D. Olds et al., is a well-known nurse home visitation program that has been tested in three randomized controlled trials (RCT) with young high-risk pregnant women[13]. The trials were conducted in three distinct populations in the United States (US): Elmira (New York), Memphis (Tennessee) and Denver (Colorado)[14–17]. The NFP has proven effective for the prevention of adverse child health outcomes including child abuse. The Denver trial detected program effects on IPV at four year follow-up [18,19]. The Elmira trial also reported program effects on IPV [13]. Olds et al. showed that home visitation programs designed to prevent child abuse and neglect have limited effectiveness if the mother is currently experiencing IPV[20]. Because of the strong links between IPV and child abuse and neglect it is important to study whether nurse home visiting is effective at reducing IPV. Langhinrichsen-Rohling et al. conducted a preliminary test of an IPV prevention program among a small group of high-risk inner-city pregnant adolescent girls in which they found an effect on IPV perpetration and victimization[21]. In the Netherlands, the NFP was translated into the Dutch language and adapted to be integrated into the Dutch health care system. Although the adapted program, VoorZorg, is the first evaluation of the NFP outside the US, other adaptations of the program are currently being evaluated in England, Canada and Australia. VoorZorg consists of 40-60 structured

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home visits with young pregnant women by well-trained nurses, from pregnancy until the child is two years of age. Primary outcome measures of the Dutch RCT are smoking cessation, birth outcomes (birth weight and pregnancy duration), breast feeding, child development, IPV and child abuse [22]. The objective of the current study is to assess the effect of VoorZorg on addressing self-reported IPV victimization and perpetration among young, low-educated pregnant women and mothers compared with young mothers receiving the usual care in the Netherlands. For the complete article click here.

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One-year follow-up of children of parents attending hospital emergency departments after intimate partner violence, substance abuse or suicide attempt dr. E.M.M. Hoytema van Konijnenburg PhD A new protocol identifies children whose parents visit the emergency department due to intimate partner violence, substance abuse or a suicide attempt, and refers these families to support services. This is a one-year follow-up study, aiming to evaluate wellbeing of children and parents and involvement of support services in the year after the emergency department visit. Data were gathered from child protective services and parent- and child self-reports.

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Care for young carers; from neglect to support P.J. Jonker MD Young carers are at risk of overburden, mental problems and an unfavourable school career. Even though it concerns many children, Young Caring is often a blind spot for the outside world, including teachers, social workers and medical professionals! And even though quite often emotional neglect is imminent, the reality of young carers stays unseen. In this workshop the features of Young Caring are brought into the spotlight through cut-outs of the award-winning documentary series Tough Cookies. We ponder on risks and pitfalls, investigate our possibilities to change their situation and share good practices.

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Prenatal child abuse and neglect I. van Kamp & drs. E.A. Landsmeer

Pregnancy is a life event and as such a vulnerable period in a woman’s life. Maltreatment in pregnancy is a broad concept and frequently appears to be a shameful and hidden problem. The mother can be abused herself in childhood and pregnancy and childbirth can trigger her own sexual traumas. Depression, anxiety andstress may have negative effects on pregnancy outcome and on the essential mother-child binding process. But pregnant women can also neglect their own health and self-care and thus jeopardize the health of the baby, by taking drugs, smoking, using alcohol etc. Domestic violence is another huge problem, that especially in pregancy will often remain unremarked. The importance of talking about all those subjects will be emphasised. Some psychiatric problems of the mother (or father) can enlarge the maltreatment. And last but not least, also sexual abuse at any moment in pregnancy may lead to adverse effects on mother and child In this workshop we will in an interactive way -by means of illustrative cases-talk about the consequences of neglect and abuse in pregnancy and what to do when you come across these problems.

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Evidential power of pyhiscal findings in child sexual abuse W.A. Karst MD & drs. L.R.A. van den Berg The interpretation of medical findings in prepubertal children examined for a suspicion of sexual abuse need to be based on the medical literature. Getting an overview of the literature is difficult, because in a lot of studies the methodology is inadequate or the results between studies are incomparable. An overview of the literature will be given.

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Performing a physical examination in child sexual abuse: Why and how? W.A. Karst MD A physical examination for the evaluation of child sexual abuse needs to be performed by a trained physician. What techniques need to be used to be able to examine all relevant anatomic structures in a reproducible way? And what forensic and medical issues need to be considered?

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The Empathic brain prof. C.M. Keysers One of the most remarkable features of human interactions is our intuitive sense that the people around us have intentions, sensations and emotions like our own. In this presentation, I will review evidence that mirrorneurons and brain regions involved in controlling our own actions, sensations and emotions become vicariously activated while we see or hear those of others. This shows that we have an empathic brain: a brain that understands others by empathically putting ourselves into the shoes of the people around us.

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A life full of love and happiness is possible after sexual abuse drs. M. Kimmel Marianne shares her personal story of sexual abuse by her father. She was abused till she was nine years old. At that age the abuse stopped, after she experienced her greatest trauma: being raped by her father and his friends. She will open up about the effect the sexual abuse had on her life. How it influenced her at almost each aspect of her life; relationships, eating, friends, work. She will give you an insight into the life of someone who experienced sexual abuse and take you on the journey from the past to the present: towards a life full of love and happiness.

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Why parents might kill their children prof.dr. F. Koenraadt In this presentation we will discuss the special position of killing one’s children compared to other fatal (domestic) crimes. Human aggression and impulsiveness play a role. The epidemiology and motives and the influence of a mental disorder in these cases will be presented and compared with results from international empirical research. Pre trial forensic mental health assessment and court decisions will be discussed.

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Cooperation between medical professionals and public prosecutors in PCF cases mr. E.H.G. Kwakman In zaken rond kindermishandeling is optimale samenwerking tussen alle betrokken actoren van groot belang. In complexe kindermishandelingzaken – zoals PCF – kan het zijn dat er 5 of meer instanties betrokken zijn, die allen onderzoek doen naar wat er gebeurd is en waarom. Ook zijn er diverse mogelijkheden om de veiligheid van betrokken kinderen op de korte of lange termijn te bewerkstelligen. Zo kan er gekozen worden voor (strafrechtelijke) maatregelen tegen de ouders – waaronder verplichte hulp – maar ook voor onder toezicht stellingen of tijdelijke opname in een ziekenhuis. Niet altijd is iedereen goed op de hoogte van elkaars (on)mogelijkheden en niet zelden wordt er zodanig langs elkaar heengewerkt dat de uiteindelijke doelstelling – het kind duurzaam veilig – niet wordt gehaald. In deze presentatie willen Eva Kwakman (landelijk officier van justitie Huiselijk Geweld en Zeden) en Rian Teeuw (voeg in) u meenemen in de complexiteit van samenwerken aan de hand van een PCF-casus. Eerst zal de casus worden geschetst vanuit het perspectief van de kinderarts. Aansluitend zal vanuit strafrechtelijk perspectief ingegaan worden op de casus en op de algemene mogelijkheden in vergelijkbare complexe zaken.

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No kids in the middle drs. M.J. van Lawick When parents fight and demonise each other after divorce, children are caught in the middle. These parents live in a truth: I am doing everything I can to rescue my child from this bad other parent. Judges, Child protection, Mediators and others can be involved. The Lorentzhuis and the KJTC (Child and Juvenal Trauma Centre) developed a program to work with these families and to stop the destructive patterns to get the children out of the middle. Research on this project is done by the VU (free University of Amsterdam).

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Abusive Abdominal Injuries: How do you find them and what do you do? D. Lindberg MD; Assc. Prof. Abdominal injuries, while uncommon, can have important medical and forensic significance, and are easily missed by the clinical examination. Risks from ionizing radiation preclude routine imaging. This talk will describe an evidence-based algorithm for occult injury screening that balances injury detection and patient safety.

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The other children: Occult injuries in siblings and contacts D. Lindberg MD; Assc. Prof. Violence is often a disease that affects the entire household and children who share a home with an abused child are at high risk for occult abusive injury. This talk will describe which of these “contact children” should have testing for occult injuries, and which tests should be performed.

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What happened to you? (Interviewing young children during police investigations) B.N. Nolet MCI Sometimes children are victim of a crime and some children witnessed a serious offence that happened to someone else. What information does the police need for their investigations and in which cases must the police interview a young child to gain access to this information? In some cases the needed information may also be available at other agencies, like hospitals or welfare, but often it takes too much effort to be made available in time. When necessary the police will interview these children. What issues does the police take into account during the interview, what are the dilemmas and how do we try to get around them?

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How can CenteringPregnancy and CenteringParenting contribute to the prevention of child abuse dr. M.E. Rijnders Centering is a model or group antenatal care (Pregnancy) and group Youth Health Care (Parenting) aimed at the empowerment and support of parents (to be). During 10 group sessions 10-12 women (and their partners) actively participate in their healthcare. A variety of topics are addressed through discussion and interactive learning. In this presentation this model of care will be explained including how themes such as preparation for parenthood, changes in relationships and abuse are addressed. Feedback of the audience and tips for potential improvements will be very much appreciated.

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Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline in Foster Care: VIPP- FC – A pilot study N.K. Schoemaker MSc Foster children often have had adverse experiences (e.g. maltreatment) in their birth families, which makes it difficult for them to form an attachment relationship with new parents. A meta-analysis showed that foster children indeed show more insecure disorganized attachment, compared to children in biological families, which is a serious risk for later psychopathology. Foster children often show behavioral signals that are difficult to interpret for foster parents, which in turn makes it hard for foster parents to respond in a sensitive manner. However, research has shown that insecurely attached children can develop secure attachment relationships if their new parents provide them with corrective positive attachment experiences.

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Talking about child maltreatment with parents; resolutions approach drs. J.W. Sepers Working together with parents in cases of (alleged) child abuse is difficult but possible. ‘The Resolutions Approach’ is a solution focused therapy.The approach was developed for families who want to reunite in cases of (alleged) abuse and for parents who partially deny the abuse. The approach has been created by Susie Essex and her colleagues and published by Turnell and Essex. In this presentation the approach will be presented on the basis of a case.

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Investigative interviewing of child witness by the Dutch police J. van der Sleen MSc When interviewing a child witness a police officer should be aware of different aspects: on one hand he should not put pressure on a child to tell what happened or influence the answers of the child. On the other hand it is also the task of a police officer to adjust to each child in such a way that the child is able to tell as complete as possible what (might have) happened. In this workshop Jannie van der Sleen will discuss how the investigative interviews of child witnesses are conducted by the Dutch police. Short video examples will be shown to illustrate this.

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Preventing Abusive Head Trauma in Children dr. B.E. van Sleuwen Abusive Head Trauma (AHT) is a preventable and severe form of physical child abuse. In The Netherlands, a nationwide campaign has been introduced, focusing on providing all newborn parents and parents-to-be with information describing the dangers of violent shaking and providing alternative responses to persistent infant crying. For this campaign, a short movie and several information materials have been developed, and a nationwide educational program for professionals has been realized. Three studies have been performed into the usability of the materials and the effect of the prevention campaign. This presentation gives an insight into these studies and the settings and conditions of the nationwide campaign.

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Combining forensic and Pediatric experience: 1 and 1 becomes 3! A.H. Teeuw & drs. H.C. Terlingen & drs. I.M.B. Russel Physical signs can be indicative for child abuse and should not be missed if present. Interpretation of signs as such can be difficult though and demand for an integrated forensic medical and pediatric perspective. During the workshop cases will be presented in which pediatric diagnosis and child abuse will be demonstrated. It will stress the importance of co-operation between the pediatrician and the forensic doctor.

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Effects of a community approach to domestic violence in the G4 drs. B. Tierolf Does the comprehensive approach to domestic violence in the four major cities of the Netherlands: Amsterdam, The Hague, Rotterdam and Utrecht, has the anticipated effect? The Verwey-Jonker Institute has done research in families where domestic violence occurred for four years. These families were followed for one and a half year with three measurements of different aspects of their home and family situation. The results of this research and of interviews with the families and caretakers are presented along with recommendations for future policies concerning domestic violence in cities.

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Workshop Photo Documentation P. Varkevisser & M. Van Velthoven & H.G.T. Nijs MD.PhD In this workshop the principles of photodocumentation will be explained. After a short introduction of the method (technical settings and sequence of photography) you will get the opportunity to shoot your own set of photographs of a (fictitious or real) injury. Feedback will be given by experienced medical forensic photographers. The focus is to improve your images for both medical and forensic purposes, by following strict procedures (also helpful when someone else actually takes the photographs, eg. a medical or police photographer). Afterwards you will receive a mnemonic (in English): a ‘credit card’ with a short checklist.

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A triage-tool to assess danger and structural unsafety in family systems L. Vogtländer MSc How to promote safety in multi-agency collaboration by applying a triage-tool at the entry of the field of domestic violence, child maltreatment and sexual abuse: 1. Assess all forms of violence and unsafety in family relations 2. Focus on all members of the system 3. Ask direct and specific questions that focus on safety and future danger. 4. Assess facts, not risks. 5. Ask for the history of violence and unsafety. 6. Realize assessment and decision - making with colleagues inside and outside the organization.

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Improving the parental relationship enhances safety for children drs. C.L.A. Wagenaar In this workshop I will explain the EFT model and how this helps couples to improve their attachment relationship. Working from an attachment perspective gives the therapist a clear map on where to go in the therapy. The focus on the underlying emotions is a powerful tool to soften conflicts. Once the couple relationship is deescalated, safety for children is improved.

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The power of partnership J. Wiggerink & M. Vogel Partnership means building a relation. A relation with every important person in a child’s life. By listening to the child and their parents you get a clear view who the people are they need to make real changes in their situation. The most simple way to create a good working relationship with parents is for the professionals to continually identify and honour the parents for everything they can see that is positive in their everyday care and involvement with their children. By building partnership we are creating a platform to talk about worries and child abuse in a way that is helping everyone to start thinking in solutions.

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Challenge your beliefs P.I.M. Worm Pediatricians and other professionals are often faced with the clinical dilemma of ‘What is going on?’ After all, doctors are trained to believe the history of mothers. When we think ‘This does not fit the usual pattern of an organic illness’ we should reflect and consult. At that moment we have to consider PCF. Pediatric Condition Falsification (PCF) can cause significant harm to children. PCF involves a healthy child being presented by a carer (parent or someone who is loco parentis) as ill or disabled, or an ill or disabled child being presented with a more significant problem than he or she has in reality, and suffering harm as a consequence.There are particular challenges for pediatricians and other professionals in terms of managing PCF.

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Abstracts abstractspeakers & Poster SLAM sessions

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Prevalence of victimization and poly-victimization of children in Saudi Arabia: Results from ICAST study dr. Al-Eissa Background Multiple forms of victimization (poly-victimization) can occur during childhood resulting harmful effects on health and difficult to reverse. Previous studies focused on individual, relatively narrow categories of victimization (e.g. psychological abuse, physical abuse, sexual abuse, and witnessing family violence), paying less attention to exposure to polyvictimization. Most studies of poly-victimization have been conducted in the United States and in northern European countries. The aim of this study is to determine the prevalence of victimization and polyvictimization among secondary school students in Saudi Arabia. Methods A cross-sectional, national survey utilizing ISPCAN Child Abuse Screening Tool Children’s Version (ICAST-CH), supported by a grant from King Abdullah International Medical Research Center (KAIMRC) was conducted in secondary schools in the five main regions of Saudi Arabia. Boys and girls, public and private schools were selected to participate. Students (N=16,010) aged 15-18 years were invited to complete the survey. Results Participant’s mean age 16.8±0.9 years, and 51% boys. Eighty one percent lived with both-parents, 6.2% with single parent, and 2.5% with stepparent. Most of the participants (89%) reported at least one type of victimization during their lives and 87% during the last year. Psychological abuse (79%) was the most common type of abuse followed by physical abuse (62%), neglect (53%), and sexual abuse (13%). Participants reported an average of 3.5±1.3 victimizations during their lives and 3.2±1.3 victimizations during the last year. Approximately 47% of the sample was considered as poly-victims (experienced 4-6 victimizations) during their lives and 38% during the last year. Poly-victimization was found to be higher in girls, 17-18 years, and living with step-parent (p